title: The association of constipation with childhood urinary tract infections.
abstract: OBJECTIVE
  Previous studies have suggested a correlation between constipation and urinary tract infections (UTIs) in children. However, historical information about constipation may be unreliable and the relationship between a history of constipation and radiographic findings of fecal load is unclear.
  
  
  METHODS
  A total of 133 children undergoing an abdominal X-ray were evaluated. Parents were asked to complete a questionnaire on bowel habits. Three observers using a documented objective scoring system evaluated plain films of the abdomen. The symptom and radiographic scores were compared with the history and each other.
  
  
  RESULTS
  Out of the 133 children, 100 had documented previous UTIs and 33 did not. Children with prior UTIs had significantly more symptoms of constipation than those without prior UTIs (p<0.02). Children with a history of UTIs tended to have more fecal loading on radiographic studies than those without, although this difference was not statistically significant (p<0.11). When only children of >3 years old are evaluated, the trends persist, but neither were statistically significant (p<0.11 and 0.56, respectively). There was a poor correlation between the symptoms of constipation and fecal load on abdominal X-rays (correlation coefficient of 0.08).
  
  
  CONCLUSIONS
  Our findings support the concept that children with UTIs have a higher rate of constipation, especially by history. However, diagnosing constipation in individual patients is difficult. Not only is there a poor correlation between history and radiographic findings of constipation in any individual patient, but at this time there is no gold standard.
authors.affiliation: The Urological Institute of Northeastern New York and Department of Surgery, Albany Medical College, 23 Hackett Boulevard, Albany, NY 12208, USA. kgiramonti@communitycare.com
authors.forename: Karla M
authors.initials: KM
authors.lastname: Giramonti
authors.forename: Barry A
authors.initials: BA
authors.lastname: Kogan
authors.forename: Olayemi O
authors.initials: OO
authors.lastname: Agboola
authors.forename: Lisa
authors.initials: L
authors.lastname: Ribons
authors.forename: Barbara
authors.initials: B
authors.lastname: Dangman